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Individual

THOMAS E REEVE III

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
157 CLINIC AVE, SUITE 302, CARROLLTON, GA 30117-4413
(770) 834-3336
(770) 832-2136
Mailing address
157 CLINIC AVE, SUITE 302, CARROLLTON, GA 30117-4413
(770) 834-3336
(770) 832-2136

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
29759
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00344539A
GA
01
271249
BLUE CROSS
GA
01
30117A003
CHAMPUS
GA
01
AETNA
5417058
GA
Enumeration date
12/02/2005
Last updated
07/08/2007
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